Purpose: To determine and compare the effects of core stability exercise programs performed in two different environments in lumbar disc herniation (LDH) patients. Method: Thirty-one patients who were diagnosed with LDH and were experiencing pain or functional disability for at least 3 months were randomly divided into two groups as land-based exercises or water specific therapy. Also, 15 age–sex-matched healthy individuals were recruited as healthy controls. Both groups underwent an 8-week (3 times/week) core stabilization exercise program. Primary outcomes were pain, trunk muscle static endurance and perceived disability level. The secondary outcome was health-related quality of life. Results: Level of static endurance of trunk muscles was found to be lower in the patients compared to the controls at baseline (p < 0.05). Both treatment groups showed significant improvements in all outcomes (p < 0.05) after 8-week intervention. When two treatment groups were compared, no differences were found in the amount of change after the intervention (p > 0.05). After the treatment, static endurance of trunk muscles of the LDH patients became similar to controls (p > 0.05). Conclusion: According to these results, core stabilization exercise training performed on land or in water both could be beneficial in LDH patients and there is no difference between the environments. Implications for Rehabilitation An 8-week core stabilization program performed in water or on land decrease pain level and improve functional status in LDH patients. Both programs seem beneficial to increase health-related quality of life and static endurance of trunk muscles. Core stability exercises could be performed in water as well, no differences were found between methods due to environment.

Currently, aquatic exercise is among the most common physical activity modalities for children with neuromuscular and neurodevelopmental disorders. However, the outcome measures that should be routinely used by therapists working in this specific health-care context have not been widely studied. The purpose of the study was to identify and compare the content of outcome measures used in aquatic physiotherapy for children, employing the International Classification of Functioning, Disability and Health (ICF) as a framework. A literature review was used to identify aquatic functioning outcome measures for children with neuromuscular and neurodevelopmental disorders. Content comparison of outcome measures identified was linked to the ICF following the linking guidelines, and content-related metrics were used to analyze them. Four outcome measures were identified (HAAR, Conatser, WOTA 1 and 2, and SWIM), which contained a total of 116 meaningful concepts and were linked to 35 ICF 2nd level categories. The greatest number of items assessed activity and participation categories. Large differences were found in reference to the density of content. For content diversity, the measures were all below 0.5. The identified outcome measurements showed homogeneity with respect to the theoretical foundation; however, some differences were found in terms of content analysis.

Spinal cord injury (SCI) is a severe medical condition resulting in substantial physiological and functional consequences for the individual. People with SCI are characterised by a chronic, low-grade systemic inflammatory state, which contributes to further undesirable secondary injuries. This study aimed to evaluate the effect of adding aquatic therapy to the standard physiotherapy treatment, implemented in two different schedules, on systemic inflammation in SCI patients. Additionally, the relationship between cytokine blood levels and changes in functionality (measured with the 6MWT, 10MWT, WISCI, BBS, and TUG tests) throughout the study was assessed. A quantitative multiplexed antibody assay was performed to measure the expression level of 20 pro- and anti-inflammatory cytokines in blood samples from SCI patients at three time points: baseline, week 6, and immediately post-intervention (week 12). This study identified a complex signature of five cytokines (IL-12p70, IL-8, MCP-1, IL-1α, and IP10) associated with the time course of the two physiotherapy programs. Two other cytokines (IL-4 and TNF-α) were also associated with the functional recovery of patients. These could be important indicators for SCI prognosis and provide a basis for developing novel targeted therapies.

Objectives: Motor impairments affect about 80% of children with autism spectrum disorders (ASD), making aquatic interventions potentially beneficial for motor development. To better tailor interventions, the Wot-ASD, an observation instrument for water-related motor skills in children with ASD, was developed. In a pilot study, feasibility, reliability, and validity were evaluated. Methods: The first stage of development involved mastering an existing instrument based on the Halliwick program. In stage 2, items were operationalised based on observed behaviours. Stage 3 validated the content with feedback from six experts. Stages 4 and 5 established scalability, interrater reliability, internal consistency and validity. A convenience sample was utilised to provide a preliminary psychometric evaluation of the Wot-ASD. The instrument’s feasibility was evaluated across all sub-studies. Results: The Wot-ASD was developed with four subscales, each corresponding to a learning phase, to assess 25 items covering 22 activities. Expert feedback supported the validity of the Wot-ASD, noting that it accurately and comprehensively assesses water adjustment skills. Preliminary results showed adequate internal consistency for all items (ICC > .81), and scale consistency with H ≥ .5 for both items and subscales, and interrater reliability was supported by a Cronbach’s Alpha > .91 for 23 items. Conclusions: This pilot evaluation of the Wot-ASD provides preliminary evidence for the feasible, reliable, and content validity when evaluating water-related motor skills in children with ASD.